A model of cost-outcome analysis for assistive technology.
During the CERTAIN study (research carried out in 1994-96 within the Technology Initiative for Disabled and Elderly (TIDE) programme of the European Union), a number of real life case studies of provision of assistive technology to disabled persons were investigated in order to assess the applicability of socio-economic principles, methods and techniques already available from Health Care Technology Assessment studies. A retrospective study on cost, effectiveness and utility resulting from the implementation of assistive technology was carried out over a sample of disabled persons who had adopted technical aids before the start of the project. The sample was selected in such a way to include different pathologies (steady or progressive), impairments, ages, technology and social environment. Each case was described by considering all clinical, technical and social aspects; a common structure for case reporting was developed and tested; attempts were carried out to apply and refine concept and tools derived from health technology assessment studies; on the grounds of such experience a decision support model was elaborated for the choice between different alternatives in order to maximize the client's quality of life while making efficient use of scarce resources. A computer implementation of such a model was also developed, along with a mathematical structure of cost analysis. Within a national research programme such findings were further exploited, leading to the development of a prototype cost-outcome instrument designed for use in clinical practice in the provision of assistive technology to individual cases.
Andrich
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R
SIVA--Assistive Technology Research and Information Service, Fondazione Pro Juventute Don Carlo Gnocchi IRCCS, Milano, Italy.
Ferrario
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M
Moi
M
M
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003362:Cost-Benefit Analysis; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012046:Rehabilitation / Q000191:economics* / Q000295:instrumentation; D012189:Retrospective Studies; D012656:Self-Help Devices / Q000191:economics*; D013673:Technology Assessment, Biomedical / Q000379:methods*